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Meningococcal Pericarditis: Clinical Features and Therapy in Five Patients

Meningococcal Pericarditis: Clinical Features and Therapy in Five Patients Abstract A diagnosis of pericarditis was made in five patients with acute meningococcal infections, including three from a recent series of 97 cases. Evidence for pericarditis was present in four of the five patients upon admission to the hospital, and all demonstrated the typical features of pericardial involvement, including electrocardiographic abnormalities, cardiac silhouette enlargement on x-ray film, and pericardial friction rubs. The course was uncomplicated in three patients, while two developed cardiac tamponade, necessitating pericardiocentesis. Reaccumulation of fluid was felt to be prevented by the administration of corticosteroids. A review of the past and present cases suggests that the pericarditis occurring early in the course of meningococcal disease is due to invasion of the pericardium by the organism, while its appearance later in the illness is a hypersensitivity reaction, initiated by the earlier bacterial invasion. References 1. Hardman JM, Earle KM: Myocarditis in 200 fatal meningococcal infections. Arch Path 87:318-325, 1969. 2. Daniels WB: Cause of death in meningococcic infections: Analysis of 300 fatal cases. Amer J Med 8:468-473, 1950.Crossref 3. Gore I, Saphir 0: Myocarditis: A classification of 1,402 cases. Amer Heart J 34:827-830, 1947.Crossref 4. Moritz AR, Zamcheck N: Sudden and unexpected deaths of young soldiers. Arch Path 42:459-494, 1947. 5. Herrick WW: Meningococcic pericarditis, with report of 12 cases. Med Clin N Amer 2:411-426, 1918. 6. Koslow JL, Gaston WR: Meningococcal pericarditis with massive pericardial effusion and tamponade. Progr Notes Dept Med, US Army Hosp, Fort Jackson, S Carolina 1:1-3, 1970. 7. Lipton H: Pericarditis complicating meningococcic infection in a case treated with sulfadiazine. Conn Med 15:480-483, 1951. 8. Lukash WM: Massive pericardial effusion due to meningococcic pericarditis. JAMA 185:598-600, 1963.Crossref 9. Stamey CC: Meningococcal pericarditis. N Carolina Med J 25:423-426, 1964. 10. Penny JL, Grace WJ, Kennedy RJ: Meningococcic pericarditis: A case report and review of the literature. Amer J Cardiol 18:281-285, 1966.Crossref 11. Saslaw S, Diserens RV: Purulent pericardial effusion complicating meningococcal meningitis. New Eng J Med 263:1074-1075, 1960.Crossref 12. Lebowitz WB, Nespole AJ: Purulent pericarditis complicating meningococcal meningitis. Amer J Dis Child 113:385-389, 1967.Crossref 13. Trace IM, Berkowitz C: Meningococcic purulent pericarditis complicating epidemic cerebrospinal meningitis. JAMA 97:246-247, 1931.Crossref 14. Orgain ES, Poston MA: Pericarditis with effusion due to the meningococcus. Amer Heart J 18:368-372, 1939.Crossref 15. Boyle JD, Pearce ML, Guze LB: Purulent pericarditis: Review of the literature and report of eleven cases. Medicine 40:119-144, 1961.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Meningococcal Pericarditis: Clinical Features and Therapy in Five Patients

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Publisher
American Medical Association
Copyright
Copyright © 1972 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1972.00320060066007
Publisher site
See Article on Publisher Site

Abstract

Abstract A diagnosis of pericarditis was made in five patients with acute meningococcal infections, including three from a recent series of 97 cases. Evidence for pericarditis was present in four of the five patients upon admission to the hospital, and all demonstrated the typical features of pericardial involvement, including electrocardiographic abnormalities, cardiac silhouette enlargement on x-ray film, and pericardial friction rubs. The course was uncomplicated in three patients, while two developed cardiac tamponade, necessitating pericardiocentesis. Reaccumulation of fluid was felt to be prevented by the administration of corticosteroids. A review of the past and present cases suggests that the pericarditis occurring early in the course of meningococcal disease is due to invasion of the pericardium by the organism, while its appearance later in the illness is a hypersensitivity reaction, initiated by the earlier bacterial invasion. References 1. Hardman JM, Earle KM: Myocarditis in 200 fatal meningococcal infections. Arch Path 87:318-325, 1969. 2. Daniels WB: Cause of death in meningococcic infections: Analysis of 300 fatal cases. Amer J Med 8:468-473, 1950.Crossref 3. Gore I, Saphir 0: Myocarditis: A classification of 1,402 cases. Amer Heart J 34:827-830, 1947.Crossref 4. Moritz AR, Zamcheck N: Sudden and unexpected deaths of young soldiers. Arch Path 42:459-494, 1947. 5. Herrick WW: Meningococcic pericarditis, with report of 12 cases. Med Clin N Amer 2:411-426, 1918. 6. Koslow JL, Gaston WR: Meningococcal pericarditis with massive pericardial effusion and tamponade. Progr Notes Dept Med, US Army Hosp, Fort Jackson, S Carolina 1:1-3, 1970. 7. Lipton H: Pericarditis complicating meningococcic infection in a case treated with sulfadiazine. Conn Med 15:480-483, 1951. 8. Lukash WM: Massive pericardial effusion due to meningococcic pericarditis. JAMA 185:598-600, 1963.Crossref 9. Stamey CC: Meningococcal pericarditis. N Carolina Med J 25:423-426, 1964. 10. Penny JL, Grace WJ, Kennedy RJ: Meningococcic pericarditis: A case report and review of the literature. Amer J Cardiol 18:281-285, 1966.Crossref 11. Saslaw S, Diserens RV: Purulent pericardial effusion complicating meningococcal meningitis. New Eng J Med 263:1074-1075, 1960.Crossref 12. Lebowitz WB, Nespole AJ: Purulent pericarditis complicating meningococcal meningitis. Amer J Dis Child 113:385-389, 1967.Crossref 13. Trace IM, Berkowitz C: Meningococcic purulent pericarditis complicating epidemic cerebrospinal meningitis. JAMA 97:246-247, 1931.Crossref 14. Orgain ES, Poston MA: Pericarditis with effusion due to the meningococcus. Amer Heart J 18:368-372, 1939.Crossref 15. Boyle JD, Pearce ML, Guze LB: Purulent pericarditis: Review of the literature and report of eleven cases. Medicine 40:119-144, 1961.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1972

References